Healthcare Provider Details

I. General information

NPI: 1366637563
Provider Name (Legal Business Name): AN L TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 N. OCOEE ST.
CLEVELAND TN
37311
US

IV. Provider business mailing address

605 GLENWOOD DRIVE SUITE 200
CHATTANOOGA TN
37404-1130
US

V. Phone/Fax

Practice location:
  • Phone: 423-339-0300
  • Fax: 423-709-0543
Mailing address:
  • Phone: 423-698-1844
  • Fax: 423-624-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number48335
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT189067
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: